Written by Natalie Tran | Edited by Olivia Cooper
Photo by cottonpro studio
“Botulinum toxin” carries an ominous connotation. After all, it is a neurotoxin created by Clostridium botulinum, a bacterial causative agent of botulism, a form of food poisoning, one symptom of which is paralysis [1]. However, when marketed as “Botox,” the neurotoxin adopts an entirely different connotation. Famous for its anti-wrinkle properties, Botox has long been a relatively open secret in the celebrity world. Over the course of the pandemic, it exploded in popularity with women; According to a review published by the American Society of Plastic, Botulinum toxin injections were the most performed minimally invasive procedure in 2020, with 4.4 million procedures within the United States alone [2]. Whether it is called botulinum toxin or Botox, the substance’s mechanism interferes with an intricate phenomenon that happens every time we lift a finger–or any muscle for that matter.
Of course, movement requires muscles, but muscles rarely accomplish anything in isolation, with the exception of heart muscles. Thus, the human body must have a way to tell muscles when to contract and relax, producing movement. The nervous system does exactly that, by relaying messages between the brain and muscles all over the body, so the brain can directly control movement, even at the body’s extremities. To move a muscle, neurons in the brain conceive a signal message that is carried by neurons in the spine to the muscle’s general vicinity, where specialized nerve cells relay the message to exact muscle cells.
These “messages” are primarily encoded in chemicals called neurotransmitters. Like words, different neurotransmitters convey different messages, which have meanings that can even differ depending on context. One example of such a neurotransmitter is acetylcholine, which is primarily used to elicit muscle contractions. Typically, acetylcholine is assembled and stored in nerve cells until it is released into the neuromuscular junction, a piece of empty space between nerve cells and muscle cells. From there, acetylcholine molecules bind to muscle cell exteriors, causing a cascade of changes that ultimately lead to muscle contraction [3].
However, the presence of Botox obstructs the muscle contraction pathway. Once inside the body, Botox makes its way to neurons and targets a protein that is crucial in the release of acetylcholine. After Botox blocks acetylcholine’s message, muscle cells are unable to respond to the brain’s direction since the mode of communication between the two using nerve cells is halted [4]. Thus, Botox is an effective treatment for wrinkles: a lack of muscle movement means less wrinkles since muscle contractions also lead to skin contractions, which appear as wrinkles.
Beyond wrinkles, the unique mechanism of Botox lends it to be an effective treatment for many health conditions. For those with migraines, Botox injected in the face or neck area can help mitigate pain. The mechanism for this treatment is still unclear, but scientists believe that the drug interrupts pain neurotransmitters, just as it does with acetylcholine to interrupt muscle and skin contractions [5].
References:
2. “American Society of Plastic Surgeons Unveils Covid-19’s Impact and Pent-up Patient Demand Fueling the Industry’s Current Post-Pandemic Boom.” American Society of Plastic Surgeons, American Society of Plastic Surgeons, 27 Apr. 2021, https://www.plasticsurgery.org/news/press-releases/american-society-of-plastic-surgeons-unveils-covid19s-impact-and-pent-up-patient-demand-fueling-the-industrys-current-post-pandemic-boom.
5. Reddy, Sashank. “Botulinum Toxin Injectables for Migraines.” Johns Hopkins Medicine, The Johns Hopkins University, 15 Oct. 2021, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/botulinum-toxin-injectables-for-migraines.